The development and widespread use of many different devices used to suction the nasal cavities have served to focus on the shortcomings and problems to be solved in the design of suction devices used for this purpose. Although there have been many improvements in their design, several problems have not been overcome.
All the devices until the present invention use an `anterior` route, i.e. an approach via the nostrils, or nares, to suction the nasal tract. This approach is fraught with problems, which occur in patients having either normal or pathological anatomical structure of the anterior nasal tract. In patients having a narrow nasal cavity or a severely deviated septum, anterior suction devices described in the prior art cannot be used prior to or early during the surgical procedure for correction of the defect. Thus, at the stage of the surgical procedure when most needed, suction is not available to facilitate the surgery. Even in a patient with large nostrils, a suction tube inserted into a nasal cavity through a nostril substantially obstructs the entrance to the operating field, as sinonasal surgery is usually performed through the nostrils. It is vital to remove blood and debris that accumulate in the nasal tract during surgery in order to maintain a clear surgical field. Therefore, the surgery is frequently interrupted to permit suctioning through the nostrils.
A further disadvantage of the traditional method of suctioning the nasal cavities through the nostrils is that blood drains posteriorly into the throat. To prevent blood reaching the throat, traditionally gauze packing is placed in the throat via the oral cavity of an anesthetized patient prior to surgery. Once the gauze packing is saturated with blood, blood leaks into the throat, from where it passes into the patient's gastro-intestinal tract, resulting in postoperative nausea and vomiting as well as inaccurate measurements of surgical blood loss.
The advantages of the suction apparatus of the invention are manifold. It allows the possibility of continuous suctioning of the nasal tract, thus preventing the unwanted accumulation of blood, secretions or debris in the operating field. Because the suction apparatus of the invention passes through the oral cavity, and not the nostrils, it leaves the nostrils (i.e. the access to the operating field) completely clear and does not obstruct the surgical field, thus greatly eliminating interruptions during surgery to suction the sinonasal tract. Further, the suction apparatus of the invention eliminates the necessity of having a gauze throat pack with all its attendant disadvantages. By allowing for continuous suctioning (or intermittent, if preferred) of the nasopharynx, blood, secretions and debris are suctioned into the suction tubing and do not accumulate in the throat. Thus, blood does not pass into the stomach and accurate measurement of intraoperative--and postoperative, if necessary--blood loss is possible.
An unexpected advantage of the invention is a reduction of swelling of the skin around the nose during surgery. This is achieved when the suction apparatus is in place, as the skin on the nose is "sucked down" onto the nasal skeleton, thus reducing swelling. The greater the swelling, the greater is the distortion of the nose during surgery. This is particularly important during cosmetic nasal surgery, as the surgeon must predict, intraoperatively, the postoperative appearance.
Also advantageously, once the suction apparatus of the invention is properly placed, it requires little or no manipulation, leaving the hands of the surgeon and assistants free to perform other functions.
A further advantage of the invention relates to the fact that the oral cavity, the nasopharynx and the nasal choanae are capable of receiving a wider-bore tube than are the nostrils. In this regard, the larger the diameter of the tube, the more effective is the suctioning mechanism. Thus, the present invention solves the long-felt problems and fulfills all the attendant needs existing in the field of the invention as discussed above.